National Provider Identifier

Theresa Miyashita, PHD, ATC

Theresa Miyashita, PHD, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Buffalo, NY and a listed phone number of (716) 812-8276.

NPI 1215567342Buffalo, NYAthletic Trainer

Profile Overview

NPI
1215567342
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
January 16, 2020
Last Updated
January 16, 2020

Practice Location

  • 598 Lafayette Ave Unit 207
  • Buffalo, NY 14222-1481

Phone: (716) 812-8276

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1215567342
Entity Type
Individual
Last Name
Miyashita
First Name
Theresa
Name Prefix
Dr.
Credential
PHD, ATC
Mailing Street Address
598 Lafayette Ave Unit 207
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14222-1481
Mailing Country
US
Mailing Phone
(716) 812-8276
Practice Street Address
598 Lafayette Ave Unit 207
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14222-1481
Practice Country
US
Practice Phone
(716) 812-8276
Enumeration Date
January 16, 2020
Last Updated
January 16, 2020
Sex
Female
Sole Proprietor
No
Certification Date
January 16, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)